22 Residential Program Air Source Heat Pump Rebate Application

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Energy-Smart Solutions From Your Local Electric Cooperative 2022 Residential Program Air Source Heat Pump Rebate Application SEND REBATE CHECK HERE MEMBER INFORMATION Residential Member Name Mailing Address City State Phone Email Electric Cooperative/REMC Name Electric Cooperative/REMC Account Number ZIP INSTALLATION SITE INFORMATION (If different from above) Property Description (e.g. brick rental house, rental house on corner, etc.) Contact Name Email Site Address City CONTRACTOR/INSTALLER INFORMATION (If different from member name) Contact Name Business Name Address City Phone Email State ZIP SEND REBATE CHECK HERE State ZIP SUBMITTING AN APPLICATION Applications and supporting documents may be submitted one of the following ways: Submit online via our secure portal at PowerMoves.com/rebates/residential Mail to POWER MOVES Program, c/o Wabash Valley Power, 6702 Intech Blvd., Indianapolis, IN 46278 Please make and keep a copy of the application and supporting documents for your records. If you have any questions or are having any problems, please email us at res@powermoves.com, or call us at (800) 833-2279 (M-F 7:30 a.m. to 4:30 p.m. Eastern Time) and ask for Kim Flowers. We cannot process applications if required documentation/information is not included. Please read this application carefully and include all information requested. Not submitting requested documents will significantly delay processing and may disqualify your application. Energy-Smart Solutions From Your Local Electric Cooperative 6702 Intech Blvd., Indianapolis, Indiana, 46278 (800) 833-2279 1 of 6

Energy-Smart Solutions From Your Local Electric Cooperative 2022 Residential Program Air Source Heat Pump Rebate Application What is a cold climate heat pump? A cold climate heat pump is an updated, more efficient version of a typical air source heat pump. Advancements in compressor technology allows these newer heat pumps to gather up heat from outdoors at much, much lower winter temperatures than typical heat pumps. In technical terms, a cold climate heat pump is capable of achieving a coefficient of performance (COP) of at least 1.75 when it is 5 degrees outside. That .75 might not seem like much, but that translates to a big reduction in energy consumption for the homeowner. If a traditional heat pump costs them 400 to heat in a cold, winter month, a cold climate heat pump with a COP of 1.75 would lower that cost to roughly 230, a 43% difference. How do I know if a heat pump is a cold climate heat pump and qualifies for this rebate? It’s cold where I live in the winter, isn’t my heat pump automatically a “cold climate heat pump”? The Northeast Energy Efficiency Partnerships sets the standards for what pieces of equipment qualify as a “cold climate heat pump”. You can check their directory here: https://ashp.neep.org/ 1. 1. Enter the heat pump’s AHRI certificate number 2. Click ‘Search the list’ 3. 3. Review the results. If you see your heat pump, then it meets the cold climate heat pump qualification. If you do not see it, you can reach out to the heat pump’s manufacturer for the heat pump’s “Submittal sheet”. The Submittal sheet needs to document the heat pump’s COP at 5 degrees. You can also call us with the AHRI Certificate number and we’ll be happy to check for you. 1. 2. 3. Energy-Smart Solutions From Your Local Electric Cooperative 6702 Intech Blvd., Indianapolis, Indiana, 46278 (800) 833-2279 2 of 6

Energy-Smart Solutions From Your Local Electric Cooperative 2022 Residential Program Air Source Heat Pump Rebate Application Whole Home Air Source Heat Pump Minimum unit specifications needed in order to qualify for rebate Cold Climate Heat Pump Non-Cold Climate Heat Pump SEER 16 HSPF 9.0 COP@5 1.75 SEER 16 HSPF 9.0 AHRI Reference Number* SEER* HSPF* Unit Manufacturer Name(s): Incentive Amount Requested Install Date: Outdoor Model Number(s): Indoor Model Number(s): * If multiple units are installed, list the AHRI reference number, SEER and HSPF of each unit. Multiple units will not affect your rebate amount. To determine your rebate amount, follow these three steps: 1. Select the box next to the heating system you replaced from the choices below 2. Select the column that applies to your new heat pump : Cold Climate Heat Pump or non-Cold Climate Heat Pump 3. Circle the corresponding rebate amount and list it in the “Incentive Amount Requested” box above Heating System Replaced: Electric Resistance heat Natural Gas Propane Fuel Oil Air Source Heat Pump New Construction Cold Climate Heat Pump Non-Cold Climate Heat Pump 1,500 750 1,500 750 1,500 750 1,500 750 1,500 250 1,500 Not eligible Important Information: Heat pump must be a split system; not a packaged system Heats entire home; not just a portion of the home The new heat pump uses only electricity for heating; not propane, fuel oil or natural gas To receive your rebate, you must attach these documents. AHRI Certificate (Your HVAC installer should be able to provide this for you) Proof of purchase/invoice from your HVAC installer Heat Loss/Heat Gain Calculation. Your HVAC installer should perform this calculation BEFORE INSTALLATION in order to properly size your system. Some call it a “Manual J calculation.” Installer may use any Air Conditioning Contractors of America (ACCA) approved software they prefer. Energy-Smart Solutions From Your Local Electric Cooperative 6702 Intech Blvd., Indianapolis, Indiana, 46278 (800) 833-2279 3 of 6

Energy-Smart Solutions From Your Local Electric Cooperative 2022 Residential Program Air Source Heat Pump Rebate Application Partial Home Air Source Heat Pump Minimum unit specifications needed in order to qualify for rebate Cold Climate Heat Pump Non-Cold Climate Heat Pump SEER 16 HSPF 9.0 COP@5 1.75 SEER 16 HSPF 9.0 AHRI Reference Number* SEER* Incentive Amount Requested Quantity of outdoor units (Max 2) HSPF* Unit Manufacturer Name(s): Install Date: Outdoor Model Number (s): Indoor Model Number (s): * If multiple units are installed, list the AHRI reference number, SEER and HSPF of each unit. Multiple units will not affect your rebate amount. To determine your rebate amount: 1. Select the box next to the heating system you replaced from the choices below 2. Select the column that applies to your new heat pump : Cold Climate Heat Pump or non-Cold Climate Heat Pump 3. Circle the corresponding rebate amount and list it in the “Incentive Amount Requested” box above Heating System Replaced: Electric Resistance heat Natural Gas Propane Fuel Oil Air Source Heat Pump New Construction Cold Climate Heat Pump Non-Cold Climate Heat Pump 600 250 600 250 600 250 600 250 600 250 600 Not eligible Important Information: Heat pump must be a split system; not a packaged system The new heat pump uses only electricity for heating; not propane, fuel oil or natural gas To receive your rebate, you must attach these documents. AHRI Certificate (Your HVAC installer should be able to provide this for you) Proof of purchase/invoice from your HVAC installer Heat Loss/Heat Gain Calculation. Your HVAC installer should perform this calculation BEFORE INSTALLATION in order to properly size your system. Some call it a “Manual J calculation.” Installer may use any Air Conditioning Contractors of America (ACCA) approved software they prefer. Energy-Smart Solutions From Your Local Electric Cooperative 6702 Intech Blvd., Indianapolis, Indiana, 46278 (800) 833-2279 4 of 6

Energy-Smart Solutions From Your Local Electric Cooperative 2022 Residential Program Air Source Heat Pump Rebate Application Signature Submission of this form verifies that the applicant has provided accurate information to participate in the program. Applicant further certifies that: 1. All rules and requirements of this program have been followed. 2. Applicant is a residential member of an electric cooperative member of Wabash Valley Power Alliance. 3. The rebated equipment has been installed and is operational prior to submission of this application. 4. A member electric cooperative of the Wabash Valley Power Alliance is providing the electric service to the installation site address listed on this application. 5. A pplicant understands and agrees that neither Wabash Valley Power Alliance nor its member electric cooperatives assumes any responsibility or liability arising out of or related to applicant’s participation in the POWER MOVES program. 6. Applicant will allow inspection of the rebated equipment (if requested). 7. Applicant understands applicant will not receive a rebate if applicant’s contractor fails to provide an AHRI certificate, heat loss/heat gain calculation, and invoice for the Air Source Heat Pump installed in applicant’s home. 8. Applicant gives permission to Wabash Valley Power Alliance to obtain usage information from their electric cooperative. Applicant understands that Wabash Valley Power Alliance may use the usage information provided for program evaluation and analysis. If signing in a capacity other than an individual capacity, the individual signing below hereby represents and warrants that s/he is duly authorized to execute and deliver this application on behalf of the applicant. Applicant Signature: Date: Assignment of Payment to Non-Applicant: (i.e. Contractor) By signing below, I assign the full POWER MOVES incentive amount pursuant to this application to the individual or entity designated as “Contractor/Installer” on the first page of this application, agree that such assignment can only be amended or modified in writing acknowledged by Wabash Valley Power Alliance, and further agree to hold harmless and indemnify Wabash Valley Power Alliance from any claim made for such incentive amount or from any loss resulting from the payment of the incentive amount to the assignee. Applicant Signature: Date: Energy-Smart Solutions From Your Local Electric Cooperative 6702 Intech Blvd., Indianapolis, Indiana, 46278 (800) 833-2279 5 of 6

Energy-Smart Solutions From Your Local Electric Cooperative 2022 Residential Program Air Source Heat Pump Rebate Application This program can be changed or cancelled at any time at the sole discretion of Wabash Valley Power Alliance, with or without notice. Eligibility requirements Residential members of electric cooperatives participating in Wabash Valley Power Alliance’s POWER MOVES energy efficiency programs. Please call your co-op to verify participation or see the list at www.PowerMoves.com. Program eligibility requirements are subject to change or termination with or without notice at the sole discretion of Wabash Valley Power Alliance. Program parameters All rebated equipment must be new; used or rebuilt equipment is not eligible for an incentive. Incentive items must be installed on the electric cooperative account listed on this application. Rebated equipment must meet the technical specifications listed in this application form. Application procedures and deadlines Applications should be submitted within 60 days after the project completion date. An invoice, AHRI certificate, and load calculation must be included for the application to be considered complete. Rebated equipment must be installed and operational on or after January 1, 2022 and on or before December 31, 2022. All applications should be postmarked by February 28, 2023. Ability to confirm installation (right to conduct inspection) Pre-install inspection: Wabash Valley Power Alliance reserves the right to inspect the program participant’s home to verify that equipment meeting program qualifications exists prior to providing an incentive, and the program participant agrees to provide reasonable access to the premises for such purposes. Post-install inspection: Wabash Valley Power Alliance reserves the right to inspect the program participant’s home to verify that equipment matching the information provided on the program application has been placed in service at that home, and the program participant agrees to provide reasonable access to the premises for such purposes. i. Post inspection, the program participant will have 30 days from the request date to submit any additional information requested by Wabash Valley Power Alliance. Failure to submit requested information may result in application rejection. ii. If any requested inspection finds the program participant or the program participant’s contractor did not comply with program rules and standards, any incentive received must be returned to Wabash Valley Power Alliance within 60 days of notice of such noncompliance. Wabash Valley Power Alliance reserves the right to conduct an additional post-install inspection for program portfolio evaluation, measurement, and verification (EM&V) purposes. Incentives received will not be affected by the results of this inspection. Payments The maximum total residential incentive payment per membership is 10,000 per year. The incentive payment cannot exceed 75% of the total project cost. Self-labor cannot be included in total project cost. Approved incentive payments will be made via a check or bill credit at the discretion of the local electric co-op. Wabash Valley Power Alliance reserves the right to withhold payment for products that do not meet the program requirements as determined within its sole discretion. Program funds are limited. Incentives are available on a first-come, first-served basis, subject to application approval. Incentive amounts, thresholds, and offerings are subject to change or termination with or without notice at the sole discretion of Wabash Valley Power Alliance. Wabash Valley Power Alliance is not liable for incentives promised to members as a result of a contractor misrepresenting or not verifying the rules of the program. Logo Usage Disclaimers Program applicants and program participants may not use our logo or name without prior express written permission. Wabash Valley Power Alliance and its member cooperatives i. Do not endorse any particular manufacturer, product, or system design by offering these incentives; ii. Will not be responsible for any tax liability imposed on any program participant as a result of the payment of incentives; iii. Do not expressly or impliedly warrant the performance of any installed equipment; iv. Are not responsible for the handling, storage, treatment, transportation, or disposal of any waste generated as a result of any measures for which incentives have been applied for and/or received under this program nor any resultant environmental contamination related to the same; v. Are not liable for any damage caused by the operation or malfunction of the installed equipment; and vi. Do not guarantee that a specific level of energy or cost savings will result from the implementation of energy conservation measures or the use of products funded under this program. Energy-Smart Solutions From Your Local Electric Cooperative 6702 Intech Blvd., Indianapolis, Indiana, 46278 (800) 833-2279 6 of 6

1. Enter the heat pump's AHRI certificate number 2. Click 'Search the list' 3. Review the results. If you see your heat pump, then it meets the cold climate heat pump qualification. If you do not see it, you can reach out to the heat pump's manufacturer for the heat pump's "Submittal sheet". The

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